Crisdental East Salem, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CRISDENTAL EAST SALEM, LLC

Practice address

3545 Lancaster Dr NE
Salem, OR 97305-1435

Phone

(541) 672-2747

Fax

(541) 672-2757

NPI assigned

Feb 14, 2013

Organization subpart

Yes

Parent organization

CRISDENTAL GROUP, PCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael J Bratland, DMDNPI 1235128745

Title

Owner

Phone

(541) 672-2747

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Jacob Bratland, DMD

  • General Practice Dentistry
  • Roseburg, OR
  • NPI 1235128745
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360800000000",
    "number": "1558601385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 NW STEWART PKWY",
            "address_2": "STE 304, BOX 311",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711602",
            "telephone_number": "541-672-2747",
            "fax_number": "541-672-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051435",
            "telephone_number": "541-672-2747",
            "fax_number": "541-672-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISDENTAL EAST SALEM, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRISDENTAL GROUP, PC",
        "enumeration_date": "2013-02-14",
        "last_updated": "2013-02-14",
        "status": "A",
        "authorized_official_last_name": "BRATLAND",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-672-2747",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creekside Counseling Inc
• Creekside Counseling, Inc
• Creekside Family Dental PC (Bryan K Nakagawa DMD)
• Evan Crew, OT
• Steven Clarence Crider, RPH
• Crisdental Salem L.L.C.
• Natasha Crisman
• Christopher James Cristobal, CRM
• Shawn R Criswell, LPC
• Ronald M. Crockett, D.C.

• General Practice Dentistry in Salem, OR
• Providers in Salem, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.